The road to depression: understanding the consequences of driving cessation in older women

The August International Psychogeriatrics Article of the Month is entitled “Moderating effects of social engagement on driving cessation in older women” by Nancy A. Pachana, Janni K Leung, Paul A Gardiner and Deirdre McLaughlin. This blog piece was written for us by one of the paper’s authors, Nancy Pachana.

The ability to drive is considered an important functional skill, as well as a marker of independence, by people in most age groups, including older adults. A variety of physical and /or cognitive issues can require ceasing driving at any age, but this eventuality is perhaps both more common and more concerning later in life. For some older adults, having to cease driving can not only negatively impact participation in a range of activities but can also negatively impact emotional well-being.

A recent study at The University of Queensland examined this important relationship between driving cessation and depression in an older cohort of the Australian Longitudinal Study on Women’s Health (ALSWH). It is important to examine this issue of the consequences of driving cessation in women, because international data suggests that older women are more likely to stop driving, more likely to stop driving pre-maturely, and are also more vulnerable to depression than older men.

Data from over 4000 older women aged 76-87 were analysed over a three year period. In the study driving cessation was indeed associated with poorer self-reported mental health in the sample, congruent with many studies of older men and women, published from a range of countries. However, in our study we were able to identify a protective factor, namely engagement in social activities. In our cohort, older women who remained engaged in social activities despite ceasing driving were able to maintain a higher level of mental health in the face of having ceased driving than those women who were less engaged in such activities.

This is an important finding from an intervention and policy perspective. Driving cessation programs (such as the CarFreeMe (http://carfreeme.com.au/) driving cessation intervention developed at UQ) which help to instruct older drivers about how to stay mobile via public transport, can assist in maintaining access to social activities for those who cease driving. Such interventions are being made available to increasing numbers of older adults who cease driving.

Interventions as well as policies to increase both ease of access as well as facilitate the provision of social engagement opportunities for older adults have an important role in maintaining emotional well-being, facilitating meaningful community engagement, and protecting against social isolation. From our study we suggest that social support acts as a buffer to declining mental health in those women who cease driving later in life. Attention on older women who cease driving is important, as some in this group will be widowed and unable to rely on a spouse for transport if they cannot drive themselves. The maintenance of social networks has been shown to have a wide range of benefits to emotional and physical well-being in later life, and our data shows this list includes well-being for older women who no longer drive.